A concussion is a type of mild traumatic brain injury resulting from a sudden blow or jolt to the head or body, causing the brain to move rapidly inside the skull. This forceful movement temporarily disrupts the brain’s normal function, leading to a range of symptoms. Infants and toddlers are fully capable of sustaining this type of injury. Recognizing a concussion in this age group is challenging because they cannot verbally communicate symptoms like headache or dizziness. Understanding the signs and knowing the correct response is important for caregivers because the developing brain is especially vulnerable to trauma.
Why Infants Are Vulnerable to Head Injuries
Infants face a higher risk of head injury compared to older children primarily because of their unique anatomy and developmental stage. The infant head is disproportionately large and heavy relative to the rest of the body, creating a top-heavy structure. This higher center of gravity makes them more likely to fall headfirst when they lose their balance.
Compounding this risk is the relative weakness of the neck muscles, which are still developing and provide limited support. Upon impact or sudden movement, the underdeveloped neck muscles cannot effectively stabilize the heavy head. This results in greater acceleration and deceleration of the brain within the skull, increasing the shearing and stretching forces on brain tissues and blood vessels.
The infant skull itself offers less protection than an adult’s, as the bones are softer, more pliable, and the sutures between the skull plates are not yet fused. Furthermore, the developing brain structure is less mature, with less myelination—the insulating layer around nerve fibers. These factors combine to make infants particularly susceptible to head trauma.
Identifying Non-Verbal Signs of Concussion
Because infants cannot voice their discomfort, parents must look for subtle shifts in their baseline behavior and routines. Significant changes in an infant’s usual temperament, such as becoming excessively irritable or fussy, are often the first observable signs of a problem. The baby may be unusually difficult to console or cry persistently for no apparent reason.
Alterations in feeding habits can be a telling sign following a head trauma. Caregivers should watch for the infant refusing to nurse or take a bottle, or showing a poor, weak suckle during feeding. Sudden, persistent vomiting that is not associated with a fever or a stomach virus should also raise suspicion.
Sleep patterns frequently change after a concussion. The infant may sleep significantly more or less than is typical for them. It is particularly concerning if the baby is unusually drowsy, difficult to wake up from sleep, or seems listless and tired even after resting. A loss of interest in their favorite toys or an overall decreased responsiveness to familiar stimuli can signal a change in their cognitive state.
Physical signs can include unusual eye movements, such as a lack of focus or pupils that are unequal in size. If the baby is old enough to be standing or walking, look for new difficulty with balance, an unsteady gait, or increased clumsiness. Excessive crying when the baby’s head is moved even slightly can suggest pain they are unable to localize.
Immediate Action and When to Seek Emergency Care
If an infant experiences a bump, blow, or jolt to the head, the initial step is to observe them immediately for any signs of distress or injury. If the injury involved a high speed, a fall from a significant height, or the infant lost consciousness, seek emergency medical care immediately. Never leave the infant alone after a significant head trauma, as symptoms can be delayed for hours or even days.
Certain “Red Flag” symptoms indicate a potentially severe injury that requires an immediate emergency room visit or calling emergency services. These signs include:
- Seizures or convulsions.
- Repeated or worsening vomiting.
- Increasing drowsiness or difficulty waking the baby.
- Clear fluid or blood leaking from the nose or ears.
- Any weakness or numbness.
- Pupils that are unequal in size.
A medical evaluation typically involves a thorough physical exam and a detailed history of the incident, focusing on the mechanism of injury. The medical team may observe the child for a period to monitor for developing symptoms. Imaging like a CT scan may be performed to rule out more serious injuries, such as internal bleeding. Caregivers should be prepared to provide information about the baby’s behavior before the injury, which helps establish a baseline for comparison.